Individual provider Active NPI

Jonathon Glennon, CRNA

  • Certified Registered Nurse Anesthetist
  • Lansing, MI
National Provider Identifier
1104219088
Registry record updated Mar 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704240473 Issued in MI
Practice address
4604 Old Lansing Rd
Lansing, MI 48917-4458
Phone
(517) 322-9285
NPI assigned
Mar 16, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704240473 MI Primary

Addresses

Primary practice location

4604 Old Lansing Rd
Lansing, MI 48917-4458

Mailing address

4604 Old Lansing Rd
Lansing, MI 48917-4458
Phone (517) 322-9285

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150424001530 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 8729307764 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1215 E Michigan Ave
Sparrow Crna Services
Lansing, MI 48912-1811
Phone (517) 364-2789

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Area Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Apr 15, 2015 Accepting new patients
Emergency Medical Associates, PLLC Current Accepting new patients
Capital Pathology PC Current Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Mar 9, 2015 Accepting new patients
Edward W. Sparrow Hospital Association Nurse Anesthetist, Certified Registered CurrentSince Mar 9, 2015 Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

406 E Elm St
Carson City, MI 48811
Phone (517) 584-3131

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

1200 E Michigan Ave
Ste 500
Lansing, MI 48912
Phone (517) 364-5123

2900 Collins Rd
Lansing, MI 48910
Phone (517) 975-7500

805 S Oakland St
Saint Johns, MI 48879
Phone (989) 224-6881

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1104219088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4604 OLD LANSING RD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489174458",
            "telephone_number": "517-322-9285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4604 OLD LANSING RD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489174458",
            "telephone_number": "517-322-9285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENNON",
        "first_name": "JONATHON",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-16",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704240473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.